The natural history, transmissibility, and treatment of oropharyngeal gonorrhea have been incompletely examined in previous studies. We repeated cultures on 60 patients with untreated pharyngeal gonorrhea, before treatment. The probability that the culture would remain positive decreased progressively as the interval between cultures increased, suggesting self-limited colonization. Gonococci were easily grown from expectorated saliva in 34 of 51 cultures from patients with oropharyngeal gonorrhea, suggesting transmissibility and providing another reason for ensuring effective treatment. Five treatment regimens were evaluated in 292 cases of oropharyngeal gonorrhea. Compared with aqueous procaine penicillin G, single-dose ampicillin and spectinomycin had unacceptably higher failure rates, and oral tetracycline given for 5 or 7 days was shown to be effective. A simple oral regimen providing a second dose of ampicillin plus probenecid 8 to 14 hours after the first dose was also effective.

The authors prospectively identified 96 consecutive nursing home residents (NHR) admitted to the medical wards of their affiliated hospitals to determine the outcome of hospitalization for these patients in comparison with 88 admissions in a similarly aged community residents (CR) population. Nursing home and community resident groups were similar in age, sex, marital status, and distribution among the four study hospitals. Dementia was a more common preexisting diagnosis in NHR than in CR. Reasons for admission differed between the two groups. Although NHR experienced a longer hospitalization than CR, frequency and duration of intensive care unit admissions were similar. Fatal outcome occurred more commonly in NHR compared with CR (27 v 11%, P less than .001). Predictors of mortality were examined. Nursing home residents also experienced a higher mortality than CR within the six months after hospitalization (35 v 20%, P less than .005).